Mental Health Care and Average Happiness: Strong Effect in Developed Nations


Mental disorder is a main cause of unhappiness in modern society and investment in mental health care is therefore likely to add to average happiness. This prediction was checked in a comparison of 143 nations around 2005. Absolute investment in mental health care was measured using the per capita number of psychiatrists and psychologists working in mental health care. Relative investment was measured using the share of mental health care in the total health budget. Average happiness in nations was measured with responses to survey questions about life-satisfaction. Average happiness appeared to be higher in countries that invest more in mental health care, both absolutely and relative to investment in somatic medicine. A data split by level of development shows that this difference exists only among developed nations. Among these nations the link between mental health care and happiness is quite strong, both in an absolute sense and compared to other known societal determinants of happiness. The correlation between happiness and share of mental health care in the total health budget is twice as strong as the correlation between happiness and size of the health budget. A causal effect is likely, but cannot be proved in this cross-sectional analysis.

This is a preview of subscription content, access via your institution.

Fig. 1
Fig. 2


  1. 1.


  1. Achterhuis, H. (1980). De markt van welzijn en geluk: een kritiek van de andragogie [The Well-Being and Prosperity Market]. Baarn: Ambo.

    Google Scholar 

  2. American Psychiatric Association. (2000). Diagnostic and statistical manual IV: Text revision (DSM-IV-TR). Washington: American Psychiatric Association.

    Google Scholar 

  3. Angermeyer, M. C., Breyer, P., Dietrich, S., Kenzine, D., & Matschinger, H. (2005). Public attitudes toward psychiatric treatment: An international comparison. Social Psychiatry and Psychiatric Epidemiology, 40(11), 855–864.

    PubMed  Article  Google Scholar 

  4. Bălţătescu, S. (2006). Transition is over, wait to see the benefits: A comparative evaluation of the effects of post-communist transition on life satisfaction. Paper presented at 2nd CEU Graduate Conference in Social Sciences. The End of Transitions? Central and Eastern European Countries in Comparative Perspective. Budapest (May 5–7).

  5. BBC. (2006). The happiness formula: Opinion poll. Retrieved April 13, 2013, from

  6. Deaton, A. S. (2008). Income, health, and well-being around the world: Evidence from the Gallup World Poll. Journal of Economic Perspectives, 22(2), 53–72.

    PubMed Central  PubMed  Article  Google Scholar 

  7. Dehue, G. C. G. (2008). De depressie-epidemie: Over de plicht het lot in eigen hand te nemen [The depression epidemic]. Amsterdam: Augustus.

    Google Scholar 

  8. Easterlin, R. A. (1974). Does economic growth improve the human lot? some empirical evidence. In P. A. David & M. W. Reder (Eds.), Nations and households in economic growth: Essays in honor of Moses Abramovitz (pp. 89–125). New York, NY: Academic.

    Google Scholar 

  9. Easterlin, R. A. (1995). Will raising the incomes of all increase the happiness of all? Journal of Economic Behavior and Organization, 27(1), 35–47.

    Article  Google Scholar 

  10. Easterlin, R. A. (2005). Feeding the illusion of growth and happiness: A reply to Hagerty and Veenhoven. Social Indicators Research, 74(3), 429–443.

    Article  Google Scholar 

  11. European Commission. (2006). Special eurobarometer 248: Mental well-being. Retrieved March 13, 2007, from

  12. Frances, A. J. (2012). DSM 5 is guide not bible—ignore its ten worst changes. In Psychology today: DSM 5 in distress. Retrieved May 7, 2013, from

  13. Freund, R. J., Wilson, W. J., & Sa, P. (2006). Regression analysis: Statistical modeling of a response variable (2nd ed.). Burlington: Academic.

    Google Scholar 

  14. Furedi, F. (2004). Therapy culture: Cultivating vulnerability in an uncertain age. London: Routledge.

    Google Scholar 

  15. Hagerty, M. R., & Veenhoven, R. (2003). Wealth and happiness revisited: Growing national income does go with greater happiness. Social Indicators Research, 64(1), 1–27.

    Article  Google Scholar 

  16. Harding, S. D. (1985). Values and the nature of psychological well-being. In M. Abrams, D. Gerard, & N. Timms (Eds.), Values and social change in Britain (pp. 227–252). London: McMillan.

    Google Scholar 

  17. Healy, D. (2012). Pharmageddon. Berkeley: University of California Press.

    Google Scholar 

  18. ISS. (2013). Data indices of social development. Retrieved May 6, 2013, from

  19. Kaufmann, D., Kraay, A., & Mastruzzi, M. (2008). Governance Matters VII: Aggregate and Individual Governance Indicators, 1996–2007. World Bank Policy Research Working Paper No. 4654.

  20. Layard, R. (2005). Happiness: Lessons from a new science. London: Penguin.

    Google Scholar 

  21. Lyubomirsky, S., King, L., & Diener, E. (2005). The benefits of frequent positive affect: Does happiness lead to success? Psychological Bulletin, 131(6), 803–855.

    PubMed  Article  Google Scholar 

  22. Rissmiller, D. J., & Rissmiller, J. D. (2006). Evolution of the antipsychiatry movement into mental health consumerism. Psychiatric Services, 57(6), 863–866.

    PubMed  Article  Google Scholar 

  23. Roth, A., & Fonagy, P. (2005). Conclusions and implications. In A. Roth & P. Fonagy (Eds.),  What works for whom? A critical review of psychotherapy research (2nd ed., pp. 479–510). New York/London: The Guilford Press.

  24. Trimbos, C. J. B. J. (1975). Antipsychiatrie: Een Overzicht [Anti-psychiatry: An overview]. Deventer: Van Loghum Slaterus.

    Google Scholar 

  25. UNDP. (2007). Human development report 2007/2008: Fighting climate change: Human solidarity in a divided world. Retrieved May 6, 2013, from

  26. UNDP. (2011). Human Development Report 2011: Sustainability and equity: A better future for all. Retrieved April 23, 2013, from

  27. Unger, R., & Schulze, A. (2013). Can we really (all) work longer? Trends in healthy life expectancy according to social stratum in Germany. Comparative population studies. Zeitschrift für Bevölkerungswissenschaft, 38(3), 565–582.

    Google Scholar 

  28. Van Gageldonk, A., & Donker, M. (1999). Effectiviteit van de Geestelijke Gezondheidszorg. Een Empirische Plaatsbepaling [The effectiveness of mental health care]. Tijdschrift Voor Gezondheidswetenschappen, 77(3), 169–175.

    Google Scholar 

  29. Veenhoven, R. (1984). Conditions of happiness. Dordrecht: Springer.

    Book  Google Scholar 

  30. Veenhoven, R. (1999). Quality-of-life in individualistic society: A comparison of 43 nations in the early 1990s. Social Indicators Research, 48(2), 159–188.

    Article  Google Scholar 

  31. Veenhoven, R. (2010). Life is getting better: Societal evolution and fit with human nature. Social Indicators Research, 97(1), 105–122.

    PubMed Central  PubMed  Article  Google Scholar 

  32. Veenhoven, R. (2012). Happiness: Also known as life satisfaction and subjective well-being. In K. C. Land, A. C. Michalos, & M. J. Sirgy (Eds.), Handbook of social indicators and quality of life research (pp. 63–77). Dordrecht/Heidelberg/London/New York: Springer.

  33. Veenhoven, R. (2013a). Average happiness in 149 nations 2000–2009. In World Database of Happiness. Retrieved April 23, 2013, from

  34. Veenhoven, R. (2013b). Happiness in nations. In world database of happiness. Retrieved April 23, 2013, from

  35. Veenhoven, R. (2013c). Measures of happiness. In world database of happiness. Retrieved April 23, 2013, from

  36. Veenhoven, R. (2013d). States of nations: Data file to be used for the cross-national analysis of happiness. In world database of happiness. Retrieved April 23, 2013, from

  37. Veenhoven, R. & Vergunst, F. (forthcoming). The Easterlin Illusion: Economic growth does go with greater happiness. International Journal of Happiness and Development.

  38. Wang, P. S., Aguilar-Gaxiola, S., Alonso, J., Angermeyer, M. C., Borges, G., Bromet, E. J., et al. (2007). Worldwide use of mental health services for anxiety, mood, and substance disorders: Results from 17 countries in the WHO World Mental Health Surveys. The Lancet, 370(9590), 841–850.

    Article  Google Scholar 

  39. WHO International Consortium in Psychiatric Epidemiology. (2000). Cross-national comparisons of the prevalences and correlates of mental disorders. Bulletin of the World Health Organization, 78(4), 413–426.

    Google Scholar 

  40. World Health Organization. (2005a). Atlas data on the interactive site. In WHO Project Atlas. Retrieved April 23, 2013, from

  41. World Health Organization. (2005b). Mental Health Atlas 2005: Global results. Retrieved April 23, 2013, from

  42. World Health Organization. (2011). Mental health Atlas 2011. Retrieved April 23, 2013, from

Download references

Author information



Corresponding author

Correspondence to Giorgio Touburg.



See Table 4

Table 4 Variables used in the cross-national analysis and their descriptive statistics

Rights and permissions

Reprints and Permissions

About this article

Verify currency and authenticity via CrossMark

Cite this article

Touburg, G., Veenhoven, R. Mental Health Care and Average Happiness: Strong Effect in Developed Nations. Adm Policy Ment Health 42, 394–404 (2015).

Download citation


  • Subjective well-being
  • Happiness
  • Cross-national
  • Public health
  • Mental health care